This is a review of the basic properties, standards, and regulations t
hat are correlated to the application and safety of ceramic femoral he
ads for hip endoprotheses. The investigation of more than 150 retrieve
d femoral heads (revisions and autopsies) provides information about t
he reasons of the failures and was basis for projects to improve ceram
ic femoral heads. The revision on a hip endoprothesis is mostly caused
by aseptic loosening of the stem or the socket. Failures because of m
aterials properties, e.g. fracture of a stem or because of an infectio
n are quite seldom. Because of this investigation it can be concluded
that the Biolox femoral head is a safe component in a hip endoprothesi
s. Based on 20 years clinical experience the in vivo failure rate is l
ess than 0.02% for Biolox femoral heads, 0.01% for heads wite 28mm dia
meter.